If a head injury is described as penetrating without skull penetration, how should it be coded?

In the scenario where a head injury is described as penetrating without skull penetration, coding it as a scalp laceration is the most appropriate choice. This is because a scalping injury refers specifically to damage or a cut that affects the scalp or outer layer of the head rather than involving deeper structures such as the skull or brain.

When an injury is described as "penetrating," it often indicates that there is a breach in the skin or protective layers without necessarily involving the brain or causing a skull fracture. Since the injury does not penetrate the skull, it rules out coding as a skull fracture or brain injury, as both of these options imply a more severe level of trauma affecting deeper structures. A concussion, while also a form of brain injury, particularly implies a functional disturbance of the brain rather than a physical laceration of the scalp.

Thus, the most fitting coding for a penetrating head injury that does not reach the skull remains a scalp laceration, as it appropriately characterizes the nature of the injury while reflecting its location.